HomeMy WebLinkAbout30143170 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3014317o^
Pin #: 46.2o.2
Proiect Address: 1260 E McFadden Avea
Assessor's Parcel: 932-110-70 Lot: NA
Unit: A
Block: NA
Bldg:
Tract. NA
Address Range: 1250-1272
Historic: No
Suite Range:
Zoning: R4
Owner:
Address:
Esmeralda Villarruel
1260 E McFadden Ave, A
Santa Ana, CA 92705
(7141 8s1 -865s
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Hose Bibb
General Plan Update
lssuance
Microfilm Records
Amount
16.67
23.79
s9.30
4.05
Qty
1.00
1.00
1 .00
1.00
3r-rl4
g: 35
s248.
Auth*:u{
Fee
$16.67
$23.79
$5e 30
$4 0s
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Batch+:5?254 5/21/2fi21
Off ice: (:TYH Trnnsi: 3Accti: Refi:
Rcpti; tr3292284 3/21/2tfi1
Transoct ion Totql
Esrerslds Uillnrr'uel
Building Use.
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Hose Bib
Notes:lnstall new hose bib
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Amsden, Julie
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Occupancy.
Constr Type:
Code:
Date:
Date.
Date:
R-3
VB
cPc 2019
05t21t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23 79
$75 97
$4 0s
Fee Total:
Paid to Date:
Balance Due:
$1 03 81
$0 00
$103.81
lnspector MrD#' 2021-166288
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILIIER. DEI ARATION
I hmby affm undc pctrslty of pgjury thd I m qmpt from th€ Cofrac16' Lirc kw for tlE folbwiDg roa (Se.7031.5
Buinas 8nd Prcfcsion Codc): Any City or Couty which rcquiro a pcnit to @Etrucq altq, improvg dmlish or rcpair my
st uctur, prior to it! iswcq also rcquiH thc eplicfit for such pcrmit to filc I sigDcd stdamr thd hr or slE ir licasrd puBret
to thc provisioB of thc Cortstor's Licmsod Law (Ch!pt6 9. Comming with Scrion 7000 of Division 3 of thc BBiBard
ProfBioB Codc) or thlr hc or shc b qmF thc€Aom ad ilE bcsb for thc rlkgGd qmption. Any viohtioo of Sccbn 703 I .5 by my
spplicut for E psmit 3ubjEt tbc applidt !o I civil pcuty of mt mrc the livc hundrcd dollm (t500).
A{ * omr of thc propcrty, or my mplo}B with wag6 I thcir slc @mpcrEation. wil do thc wr* sd thc structw is rct
imqdcd or offcrcd for $lc (38.7044, BuitB ud Profeshu Codc: Thc Contraclor's Lic@ Law do6 not apply to & owG of '
th€ Fopqty who buil& or irryos thaot! Ed who do6 $eh wr* hirelf or h6elf or thrcugh hir or hr om oplole,
prcvklcd that such itrlFoEc{s m mt htqd.d fi ofrrld br slc. l[ how. th. building or imprcEEil is rcld withio orc ]ry
of omplaio4 thc olvu Buildc wi[ haE rhc hda of pmvirg 0u hc u shc dil mt build tr itqrorc thc popoty br th prpos of
slc).
-1,
u omq of thc pmpcty, m acluivcly contracling with licoscd @nfrcloB to @rstrud tlE prcjet (Sc. 7044, BGiB
ard Proftssim Corlc: Thc Cotrretor's Licmc Law dG not agply to e owtr6 of prcpqty who builds or imprcv6 thmD.
ud who snlstt for such Fojcds wilh E Cofrcto(s) lic@lod pBut to thc Cotr8c1or's Lic@ kw).
-l
am exempt undcr Section-, B. & P '}lil/
o",.' 6;- &\- L\
I hereby alfirm undcr penalty of po'jury one of the following
-l
have and will maintain a Ccrtificate of Consmt to Self-Insurc for workcrs' compcosation, as providcd for by Section 37@ of the
labor Code for the performance of the work for which the pcrnrit b issued.
-l
have and will maintain workers' compcmation insurance. as rcquired by Section 3700 of the Labor Code, for the performance of
the work for which this permit is issuod. My workers' comperuiation insurance carrier and policy numhr are:
in the performance of the work for rvhich this permit is issued. I shall not qnploy any person in any manner
if I should become subject to the
comply wilh thosc provisioru..
so as to become subject to the workcrs'compensation laws of California, and agrec that
workcrs' compqnation provisions of Section 3700 of the labor Code I slull. forthwith
WARNTNG: Failurc to sccure workcrs' compcnsation coverage
civil fines up to onc hundred thousand dollars ($100.000), in
Section 3076 of the labor Code, interest and attorney's fees.
is unlawful, and shall subject an employer to criminal penalties and
addition to the cost of compcnsation. damages as provided for the
,",., 6-[\- t\
I hereby affrm under penalty of perjury tha I am licensed 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
Liccnsc Class: Liccrse Number:
I ):r I r.'f ana;aatnr.
W
I hcrcby affm uda FEhy of pqjury thd th@ b a @trdructbtr knding agcy for thc pqfoIr@cc of thc wu* br wiich thb pqoit b
isucd (Se. 3097. Civ. C.).
lrndcr's Name:
Lcnder's Address:
APPLICANT DECI..ARATTON
I hcrEbyaffirm under pcnalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Foderal Regulations (Title 40. Part6)
-Required
Lctter of Notification
_l certi& tha the federal regulations regarding asbestos rernoval are not applicable to this project.
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Poo! Pipinq
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release ,t t
FINAL tol I th:J-,rNao
Notes Remarks Etc.
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2l cariry tU I ta* rqd thb ,pptierios ed 3t.tc thd 0E rborc infonndion is corGl. t agc to smply with all Cty and Couny
ordiM dd Stdc t w rclding to buiuing @osruction ad tlrcbyrutlDria rrDrsatotiv6 of thi! City ed Couty to qrtq upos thc:,,,-,:^ilil:" ** 5- Ll-8.l
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